Provider Demographics
NPI:1790718625
Name:PATEL, SHAILESHKUMAR CHANDUBHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAILESHKUMAR
Middle Name:CHANDUBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SHAILESH
Other - Middle Name:C
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:BAKERSFIELD
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-635-2950
Mailing Address - Fax:661-635-2983
Practice Address - Street 1:1600 E BELLE TER
Practice Address - Street 2:BAKERSFIELD
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-3871
Practice Address - Country:US
Practice Address - Phone:661-635-2950
Practice Address - Fax:661-635-2983
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0634162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A634161Medicare ID - Type UnspecifiedPROVIDER #